AcctPositions

Under the direct supervision of the Service Fee Supervisor the position is responsible for front-end billing responsibilities and data collection and review. Communicate with direct care program staff as needed. Comply with all agency standards, rules, practices, and procedures. Eligibility verification using electronic software for all Insurance types. Open and close clients in Net Smart Enter and update Medicaid, Medicare and Managed Care rates in Net Smart Enter client information into electronic health record. Follow up corrective action plans. Perform other tasks as assigned. QUALIFICATIONS: High School Diploma or GED, Billing Certification, preferred. 3-5 years of work experience in related field is required. Experience working with Medicaid, Medicare and Managed Care. Experience with Electronic billing software, Net Smart preferred. Proficiency in word processing and spreadsheet applications is essential. We are an equal opportunity employer...

Position Summary: The Out-of-Network Authorization Specialist is responsible for securing prior authorizations and verifying benefits for services rendered by providers who are not contracted with a patient’s insurance plan. This role requires strong communication skills, attention to detail, and a deep understanding of payer policies to ensure accurate billing and minimize claim denials. Key Responsibilities: Initiate and follow up on prior authorization requests for out-of-network services. Verify patient insurance benefits and eligibility for out-of-network coverage. Communicate with insurance companies to determine coverage levels, out-of-pocket costs, and authorization requirements. Track and document authorization status in the EMR and billing systems. Work closely with billing and collections teams to resolve denied claims and appeals. Stay current with payer-specific guidelines and regulatory changes affecting out-of-network billing. Team player and...